罗伯特·欧文斯（Robert C. Owens）
Heart disease is not only the number-one killer offirefighters，但是人类的第一杀手。消防员提出了独特的挑战，因为暴露于烟雾颗粒，压力，睡眠剥夺, personal protective equipment (PPE), and the environment in which we perform our duties. In the case of the firefighter cardiac arrest, we must adjust our everyday tactics and treatment to provide an avenue for the most successful outcome.
All emergency service providers and even many citizens are familiar with the American Heart Association Chain of Survival, which works very well for the everyday citizen cardiac arrest. With a little adaptation, it can work well for the firefighter cardiac arrest. Let’s examine the links in the chain.
Early Access:如果消防员陷入心脏骤停，则必须迅速处理治疗团队。在警报之前通过在最初的警报分配中获得足够的资源来开始在警报之前开始，以适当的员工rapid intervention公司(RIC)和执行EMS功能。在event of a Mayday, the RIC must rapidly deploy, access, and remove the down firefighter to the exterior of the fire building and turn them over to a dedicated EMS crew for treatment. If the event occurs on the exterior, rapid deployment of EMS resources needs to be the priority. In the case of limited EMS resources, the RIC can deploy to that location and begin treatment. Mutual aid should also be considered to properly staff critical fireground components.
Early Cardio Pulmonary Resuscitation (CPR):Early CPR is imperative in any cardiac arrest. Hard and fast compressions with little to no pausing are a critical link in the chain to obtain Return of Spontaneous Circulation (ROSC). American Heart Association statistics also indicate the quality of CPR is directly related to the percentage of ROSC, as well as successful discharge from medical facilities after cardiac arrest1。However, the obstacle for the firefighter is the PPE we often wear while performing our tasks. Rapid removal of gear must take place. Initial RICs can initiate hands only CPR while EMS resources are being deployed and the remainder of PPE is being removed. Take caution while removing PPE as it may be super-heated and could cause burn injuries to unprotected hands of EMS providers. Structural firefighting gloves are recommended for removal of PPE.
早期除颤：除颤是纠正心脏中危险心律失常或电活动的关键成分。至少，EMS资源需要快速访问自动化的外部除颤器（AED）。如果可能的话，这将成为RIC工具补充的一部分，并应列入所有设备的最低设备清单。这将确保AED可随时可用，并且可以在部署的情况下替换2。
早期护理：高级护理和逮捕后护理是幸存消防员心脏骤停的最终关键联系。通过确保可以在现场向心脏骤停的受害者提供高级护理，可以在事件发生之前再次将其放置。将其他单位添加到警报任务，建立互助协议，并与当地医院谈论将医疗团队部署到重大事件中的部署 - 无论为心脏骤停受害者提供高级护理所需的一切。如果建立了ROSC，则高级护理提供者的复苏后护理对于防止重新逮捕更为关键。事件发生后，资源需要能够快速部署并将现场退出到适当的医疗机构。
使用这种消防员心脏骤停链可为如何治疗现场消防员心脏骤停提供指南。重要的是要与所有响应伙伴解决资源需求，这些响应伙伴可能与消防员患者的治疗和运输有关。与任何技能一样，必须进行培训以确保成功。消防员心脏骤停是一个非常真正的问题。这些事件正在迅速成为“何时”，而不是“如果”。我们归功于我们的兄弟姐妹消防员以及他们的家人准备照顾他们，并照顾我们服务的公民。你会准备好吗？
References
Sunde，K。（2013年，6月25日）。Wake up, CPR providers: High-quality CPR is wanted and needed!。2014年10月15日访问http://my.americanheart.org/professional/sciencenews/wake-up-cpr-providers-high-quality-cpr-is-want- and-wanted-and-need_ucm_452907_article.jsp。
美国心脏协会。（2012年2月21日）。除颤。2014年10月15日访问http://www.heart.org/heartorg/conditions/arhhythmia/preventiontreateatmentofarhhythmia/defibrillation_ucm_305002_article.jsp
罗伯特·欧文斯（Robert C. Owens）。is an engine company lieutenant with the Henrico County (VA) Division of Fire. He began his fire service career with the Mechanicsville (VA) Volunteer Fire Department. He previously served as a career firefighter in Stafford County, Virginia. He is a Virginia Department of Fire Programs-certified instructor 2 and fire officer level 4 and a mass casualty incident management instructor for the Virginia Office ofEMS。他拥有哥伦比亚南部大学的消防科学学士学位。
